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TOP 10 TAKEAWAY MESSAGES:
Anti-obesity Medications
1. Anti-obesity medications are a tool for the treatment of
overweight and obesity, not a cure.
2. Anti-obesity medications must be used in conjunction with
lifestyle modification.
3. The weight loss response to anti-obesity medications is variable.
4. Weight regain is likely to occur if anti-obesity medications
are discontinued. As such, patients should be advised on the
importance of long-term use.
5. Phentermine is a sympathomimetic amine approved by the
Food and Drug Administration (FDA) for short-term use, i.e., 12
weeks. Although not consistent with the prescribing information
indicated use, phentermine administration for longer than 12
weeks is supported by clinical data and opinion leaders.
6. Anti-obesity medications approved for the long-term treatment
of common, polygenic obesity include phentermine HCl-
topiramate extended release, naltrexone-bupropion sustained
release, liraglutide, semaglutide, tirzepatide, and orlistat.
7. Setmelanotide is the only anti-obesity medication approved for
monogenic obesity due to POMC, PCSK1, or LEPR deficiency and
for Bardet-Biedl syndrome.
8. All anti-obesity medications have side effects and
contraindications that must be considered before starting them.
All anti-obesity medications are contraindicated in pregnancy or
during breastfeeding.
9. All anti-obesity medications, except for orslistat, must be slowly
titrated up to minimize side effects.
10. Based on pivotal trials, tirzepatide leads to the most average
weight loss after 1 year, and semaglutide is the only anti-obesity
medications demonstrating beneficial cardiovascular outcomes
in patients with overweight or obesity and known cardiovascular
disease.
Anti-obesity Pharmacotherapy
